Brain Power

An ultrasound device used by UCLA doctors to treat a patient recovering from a coma

Written by Brian Haas

On a campus known for its pioneering advances in medicine and science, a study published in November 2016 stood out among UCLA’s more remarkable recent achievements. The article, in
Brain Stimulation, described a procedure in which doctors used ultrasound to restart the brain of a young man who had been in a coma.

The patient, then 25, had been involved in a March 2016 car crash. Although he had emerged from the coma, he remained barely responsive, unable to respond to doctors other than by moving his
eyes in one direction or another.

“He was telling us, ’I am in here,’” says Martin Monti, the lead author of the study and a UCLA associate
professor of psychology and neurosurgery. “He just couldn’t do much more than that.”

Martin Monti with a 3-D brain image

Typically, doctors would treat people with that level of brain activity by drilling a hole in the skull and implanting electrodes to send signals to the thalamus. The process, called deep brain
stimulation, is invasive, risky and difficult to monitor.

So Monti and his colleagues devised an alternative. Using a technique that had never been used to treat severe brain injuries, they trained a low-intensity focused ultrasound on the man’s
thalamus, allowing acoustic energy to stimulate the brain.

Monti

The results were dramatic and immediate.

“By the day after the procedure, the patient seemed to recognize objects,” Monti says. “He tried to use a spoon. He started trying to vocalize, and he clearly responded by eye
blinking.”

Three days later, the man had regained full consciousness and was responding to language by nodding his head. Within five days, he was walking. And six months later, Monti says, it would have been
difficult to tell the man had ever been in a coma.

Monti has since used the technique on a second patient, with similar but more modest results. And although much more research is needed, the prospect of a noninvasive treatment could offer hope
for people suffering from serious brain injuries, including those in a persistent vegetative state, or for those with epilepsy, depression and physical pain related to neurological disorders.

“If this really contributes to helping recovering patients have a little more autonomy, have a little more ability to interact with the world, have a little more anything,” Monti says,
“then I’ll feel like I've done something in this world to be of help.”